JK
@julianklug.bsky.social
MD. Researcher @unige_en.
Research | Machine Learning | neurovascular care | intensive care enthusiast.
Research | Machine Learning | neurovascular care | intensive care enthusiast.
New evidence showing that 🧠 brain networks become more resilient to subsequent lesions after a first ischemic stroke – fresh out in @braincomms.bsky.social from the #GenevaStrokeLab - doi.org/10.1093/brai...
June 7, 2025 at 2:31 PM
New evidence showing that 🧠 brain networks become more resilient to subsequent lesions after a first ischemic stroke – fresh out in @braincomms.bsky.social from the #GenevaStrokeLab - doi.org/10.1093/brai...
We found:
- Effective decrease in core T°C
- Small decrease in PtO2, without signs of ischemia
- Maintained cerebral perfusion pressure
- Decrease in heart rate associated with the decrease in PtO2
🧵(7/n)
- Effective decrease in core T°C
- Small decrease in PtO2, without signs of ischemia
- Maintained cerebral perfusion pressure
- Decrease in heart rate associated with the decrease in PtO2
🧵(7/n)
May 13, 2025 at 8:45 PM
We found:
- Effective decrease in core T°C
- Small decrease in PtO2, without signs of ischemia
- Maintained cerebral perfusion pressure
- Decrease in heart rate associated with the decrease in PtO2
🧵(7/n)
- Effective decrease in core T°C
- Small decrease in PtO2, without signs of ischemia
- Maintained cerebral perfusion pressure
- Decrease in heart rate associated with the decrease in PtO2
🧵(7/n)
We thus investigated 39 administrations of 12h diclofenac infusions in 18 febrile patients with acute brain injury AND brain tissue oxygenation monitoring 🫧 - comparing pre vs. post 🧠-status
🧵(6/n)
🧵(6/n)
May 13, 2025 at 8:45 PM
We thus investigated 39 administrations of 12h diclofenac infusions in 18 febrile patients with acute brain injury AND brain tissue oxygenation monitoring 🫧 - comparing pre vs. post 🧠-status
🧵(6/n)
🧵(6/n)
IV diclofenac bolus infusions have been shown to reduce temperature ⬇️, but have been associated with a decrease in brain oxygenation and CPP
ccforum.biomedcentral.com/articles/10....
🧵(4/n)
ccforum.biomedcentral.com/articles/10....
🧵(4/n)
May 13, 2025 at 8:45 PM
IV diclofenac bolus infusions have been shown to reduce temperature ⬇️, but have been associated with a decrease in brain oxygenation and CPP
ccforum.biomedcentral.com/articles/10....
🧵(4/n)
ccforum.biomedcentral.com/articles/10....
🧵(4/n)
💊Pharmacological options are limited and depend on the country, but include: paracetamol, metamizole and NSAIDs
If all else fails, device based cooling is the way to go 🥶
🧵(3/n)
If all else fails, device based cooling is the way to go 🥶
🧵(3/n)
May 13, 2025 at 8:45 PM
💊Pharmacological options are limited and depend on the country, but include: paracetamol, metamizole and NSAIDs
If all else fails, device based cooling is the way to go 🥶
🧵(3/n)
If all else fails, device based cooling is the way to go 🥶
🧵(3/n)
Fever 🔥 occurs frequently after acute brain injury, such as intracranial haemorrhage, stroke or traumatic brain injury 🤯 - but even small temperature elevations are associated with worse prognosis!
Guidelines therefore recommend targeting < 37.5°C
🧵(2/n)
Guidelines therefore recommend targeting < 37.5°C
🧵(2/n)
May 13, 2025 at 8:45 PM
Fever 🔥 occurs frequently after acute brain injury, such as intracranial haemorrhage, stroke or traumatic brain injury 🤯 - but even small temperature elevations are associated with worse prognosis!
Guidelines therefore recommend targeting < 37.5°C
🧵(2/n)
Guidelines therefore recommend targeting < 37.5°C
🧵(2/n)
Can extended diclofenac infusions be used to treat hyperthermia 🔥 in patients with acute brain injury 🧠 and do they affect brain oxygenation 🫧?
A thread on our latest work in @icmexperimental.bsky.social : icm-experimental.springeropen.com/articles/10....
#neuroskyence #Medsky #Critsaresky
🧵(1/n)
A thread on our latest work in @icmexperimental.bsky.social : icm-experimental.springeropen.com/articles/10....
#neuroskyence #Medsky #Critsaresky
🧵(1/n)
May 13, 2025 at 8:45 PM
Can extended diclofenac infusions be used to treat hyperthermia 🔥 in patients with acute brain injury 🧠 and do they affect brain oxygenation 🫧?
A thread on our latest work in @icmexperimental.bsky.social : icm-experimental.springeropen.com/articles/10....
#neuroskyence #Medsky #Critsaresky
🧵(1/n)
A thread on our latest work in @icmexperimental.bsky.social : icm-experimental.springeropen.com/articles/10....
#neuroskyence #Medsky #Critsaresky
🧵(1/n)
Up to date epidemiology and outcomes of ischemic stroke, ICH and SAH in the #Geneva cohort fresh out in #Neurology 🧠 - www.neurology.org/doi/10.1212/...
February 23, 2025 at 4:28 AM
Up to date epidemiology and outcomes of ischemic stroke, ICH and SAH in the #Geneva cohort fresh out in #Neurology 🧠 - www.neurology.org/doi/10.1212/...
Important signal of harm in the use of minimally invasive guided cardiac output dobutamine & volume administration in non cardiac surgery - OPTMISE-2
www.bmj.com/content/387/...
www.bmj.com/content/387/...
December 3, 2024 at 7:33 PM
Important signal of harm in the use of minimally invasive guided cardiac output dobutamine & volume administration in non cardiac surgery - OPTMISE-2
www.bmj.com/content/387/...
www.bmj.com/content/387/...
✨ While we're still on the journey toward integrating AI into clinical practice, this work represents a step toward a future where doctors are supported by AI for continuous monitoring.
For a sneak peek, check out: opsum.julianklug.com
🧵(11/12)
For a sneak peek, check out: opsum.julianklug.com
🧵(11/12)
November 16, 2024 at 5:20 PM
✨ While we're still on the journey toward integrating AI into clinical practice, this work represents a step toward a future where doctors are supported by AI for continuous monitoring.
For a sneak peek, check out: opsum.julianklug.com
🧵(11/12)
For a sneak peek, check out: opsum.julianklug.com
🧵(11/12)
i.e. when there's an increased probability of a poor outcome, the model pinpoints the specific factors driving this shift for that individual.
🧵(10/12)
🧵(10/12)
November 16, 2024 at 5:20 PM
i.e. when there's an increased probability of a poor outcome, the model pinpoints the specific factors driving this shift for that individual.
🧵(10/12)
🧵(10/12)
The model not only outperformed all prior static prognostic models, but did well enough to be of clinical interest – with an area under the ROC curve > 0.89 for all outcomes
⏳ and all predictions are dynamically updated over time
🧵(8/12)
⏳ and all predictions are dynamically updated over time
🧵(8/12)
November 16, 2024 at 5:20 PM
The model not only outperformed all prior static prognostic models, but did well enough to be of clinical interest – with an area under the ROC curve > 0.89 for all outcomes
⏳ and all predictions are dynamically updated over time
🧵(8/12)
⏳ and all predictions are dynamically updated over time
🧵(8/12)
🧠 We trained and validated the model with data from over 2,500 patients, spanning:
- Geneva Stroke Unit
- Boston's Beth Israel Deaconess Medical Center (MIMIC-3)
🧵(7/12)
- Geneva Stroke Unit
- Boston's Beth Israel Deaconess Medical Center (MIMIC-3)
🧵(7/12)
November 16, 2024 at 5:20 PM
🧠 We trained and validated the model with data from over 2,500 patients, spanning:
- Geneva Stroke Unit
- Boston's Beth Israel Deaconess Medical Center (MIMIC-3)
🧵(7/12)
- Geneva Stroke Unit
- Boston's Beth Israel Deaconess Medical Center (MIMIC-3)
🧵(7/12)
To achieve this, we employed a 𝘁𝗿𝗮𝗻𝘀𝗳𝗼𝗿𝗺𝗲𝗿 𝗺𝗼𝗱𝗲𝗹 - originally designed for language processing but equally effective for time series data📈.
Just as words form sequences, time series data points are integrated over time.
🧵(6/12)
Just as words form sequences, time series data points are integrated over time.
🧵(6/12)
November 16, 2024 at 5:20 PM
To achieve this, we employed a 𝘁𝗿𝗮𝗻𝘀𝗳𝗼𝗿𝗺𝗲𝗿 𝗺𝗼𝗱𝗲𝗹 - originally designed for language processing but equally effective for time series data📈.
Just as words form sequences, time series data points are integrated over time.
🧵(6/12)
Just as words form sequences, time series data points are integrated over time.
🧵(6/12)
💡 now, imagine having an AI assistant that perceives patterns we might miss or monitors patient data continuously when we're unavailable.
🧵(5/12)
🧵(5/12)
November 16, 2024 at 5:20 PM
💡 now, imagine having an AI assistant that perceives patterns we might miss or monitors patient data continuously when we're unavailable.
🧵(5/12)
🧵(5/12)
👪 Every time I speak with a patient's family, I wish we had better ways to answer their pressing questions:
- "Will their loved one recover?"
- "Will they face severe deficits?"
- "Could this be fatal?"
With this in mind, we set out to build a robust prognostic model
🧵(2/12)
- "Will their loved one recover?"
- "Will they face severe deficits?"
- "Could this be fatal?"
With this in mind, we set out to build a robust prognostic model
🧵(2/12)
November 16, 2024 at 5:20 PM
👪 Every time I speak with a patient's family, I wish we had better ways to answer their pressing questions:
- "Will their loved one recover?"
- "Will they face severe deficits?"
- "Could this be fatal?"
With this in mind, we set out to build a robust prognostic model
🧵(2/12)
- "Will their loved one recover?"
- "Will they face severe deficits?"
- "Could this be fatal?"
With this in mind, we set out to build a robust prognostic model
🧵(2/12)
How can we use #AI to enhance monitoring and prognostication in intensive care & stroke units? 🧠✨
A thread on our latest work in @natureportfolio.bsky.social Communications Medicine: nature.com/articles/s43...
#OPSUM #AIforBrains #NeuroSky #MedSky #ML #CritcareSky
🧵(1/12)
A thread on our latest work in @natureportfolio.bsky.social Communications Medicine: nature.com/articles/s43...
#OPSUM #AIforBrains #NeuroSky #MedSky #ML #CritcareSky
🧵(1/12)
November 16, 2024 at 5:20 PM
How can we use #AI to enhance monitoring and prognostication in intensive care & stroke units? 🧠✨
A thread on our latest work in @natureportfolio.bsky.social Communications Medicine: nature.com/articles/s43...
#OPSUM #AIforBrains #NeuroSky #MedSky #ML #CritcareSky
🧵(1/12)
A thread on our latest work in @natureportfolio.bsky.social Communications Medicine: nature.com/articles/s43...
#OPSUM #AIforBrains #NeuroSky #MedSky #ML #CritcareSky
🧵(1/12)
